摘要
目的探讨肠道屏障功能生化指标在新生儿坏死性小肠结肠炎(NEC)患儿预后判断中的应用价值。方法研究共纳入正常新生儿32例作为对照组,NEC患儿78例,收集新生儿血清学标本,应用中生金域JY-DLT肠道屏障功能分析系统检测肠道屏障功能生化指标:D-乳酸、二胺氧化酶(DAO)、内毒素(LPS),同时检测WBC、PLT、CRP、PCT等实验室指标,评估肠道屏障功能生化指标在NEC患儿预后判断中的应用价值。结果(1)NEC组患儿D-乳酸、DAO、LPS、WBC、CRP、PCT水平均高于正常新生儿,PLT低于正常新生儿,差异有统计学意义(均P<0.05);(2)非治愈组NEC患儿WBC、CRP和PCT水平均高于治愈组,PLT低于治愈组,但差异均无统计学意义(均P>0.05);(3)非治愈组NEC患儿D-乳酸、DAO、LPS水平均高于治愈组,差异有统计学意义(均P<0.05);(4)D-乳酸、DAO、LPS在NEC患儿预后判断中具有较高的诊断价值,AUC分别为0.838、0.763和0.804,诊断的cut-off值分别为46.15 U/L、8.635 mg/L和6.455 U/L。结论肠道屏障功能生化指标:D-乳酸、DAO和LPS在预测NEC患儿结局中具有较高的诊断价值,优于传统的实验室指标。
Objective To explore the application value of the serum indices of intestinal barrier function in prognosis of neonatal necrotizing enterocolitis(NEC). Methods Thirty-two healthy newborns and 78 infants with NEC were included,and their serological specimens were collected.JY-DLT intestinal barrier function analysis system was used to detect the serum indices of intestinal barrier function(D-lactate,DAO and endotoxin),and other laboratory indices(WBC,PLT,CRP and PCT).The value of the serum indices of intestinal barrier function in prognosis of NEC was analyzed. Results(1)The levels of D-lactate,DAO,endotoxin,WBC,CRP and PCT were higher,while that of PLT lower in NEC group than in control group,respectively,with significant differences(all P<0.05).(2)The levels of WBC,CRP and PCT were higher while that of PLT lower in NEC healing group than in NEC non-healing group,respectively,but with no statistically significant differences(all P>0.05).(3)The non-healing group had a significantly higher levels of D-lactate,DAO and endotoxin than healing group(all P<0.05).(4)D-lactate,DAO and endotoxin had better diagnostic values in the prognosis of neonatal NEC;the AUCs were 0.838,0.763 and 0.804 respectively,and the cut-off values were 46.15 U/L,8.635 mg/L and 6.455 U/L respectively for predicting poor outcome. Conclusion The serum indices of intestinal barrier function(D-lactate,DAO and endotoxin)had higher diagnostic values in prognosis of NEC infants than conventional laboratory parameters.
作者
贺锐
张丽秀
杨晶
韩璐
HE Rui;ZHANG Lixiu;YANG Jing;HAN Lu(Department of ClinicaL Laboratory, Maternal and Child Health Hospital of Gansu, Lanzhou,Gansu 730050,China)
出处
《中国微生态学杂志》
CAS
CSCD
2019年第6期684-688,共5页
Chinese Journal of Microecology
基金
甘肃省科技厅科技支撑计划(1304FKCA098)
中国疾病预防控制中心合生元母婴营养与健康研究项目(2017FYH013)
